Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9493
Peer-review started: May 12, 2022
First decision: June 8, 2022
Revised: June 17, 2022
Accepted: August 11, 2022
Article in press: August 11, 2022
Published online: September 16, 2022
The bone is the second most common site of thyroid cancer metastasis, after the lung. Treatment options for bone metastasis of thyroid cancer include surgery, radioiodine therapy (RAIT), external radiation therapy, thyroid-stimulating hormone (TSH) inhibition, bisphosphonates, and small-molecule targeted therapies. In most cases, thyroid carcinoma is found in the thyroid tissue; reports of follicular thyroid carcinoma with a single metastasis to the lumbar spine are rare.
We report a case of bone metastasis as the only clinical manifestation of thyroid cancer. The patient was a 67-year-old woman with lumbar pain for 7 years and aggravation with intermittent claudication who had previously undergone partial thyroidectomy of a benign thyroid lesion. No abnormal nodules were found in the bilateral thyroid glands. However, imaging studies were consistent with a spinal tumor, and the lesion was diagnosed as a metastatic follicular carcinoma of thyroid origin. We adopted a multidisciplinary collaboration and comprehensive treatment approach. The patient underwent lumbar spine surgery, total resection of the thyroid, postoperative TSH suppression therapy, and RAIT. There were no complications associated with the operation, and the patient had good posto
Follicular thyroid carcinoma is associated with early hematogenous metastasis, and the bone is a typical site of metastasis. Single bone metastasis is not a contraindication to medical procedures, and providing the appropriate therapy can result in better outcomes and quality of life for these patients.
Core Tip: Although bone metastasis from differentiated thyroid cancer is common, it is very rare for bone metastasis to be the solitary presentation of thyroid cancer. Here, we present a case of bone metastasis of follicular thyroid carcinoma with no indication of primary cancer. The patient had undergone partial thyroidectomy 20 years previously for thyroid nodules, but the pathological diagnosis at that time was a benign thyroid lesion. We employed a multi-institution, multidisciplinary team to diagnose and treat this patient, and she has had a good outcome thus far. This case highlights several important issues, such as the importance of follow-up for patients with seemingly indolent lesions and the utility of a comprehensive treatment approach.